Abstract: Objective To investigate the current status of oral frailty in the elderly patients with stroke, and to explore the influencing mechanism of social support and depression on oral frailty based on the integral conceptual model of frailty (ICFM), so as to provide a theoretical basis for improving the oral health of elderly stroke patients. Methods A total of 400 elderly stroke patients who visited Department of Neurology, Beijing Geratric Hospital were selected from October 2024 to July 2025. The Geriatric Depression Scale (GDS-15), Social Support Rating Scale (SSRS), and Oral Frailty Index-8 (OFI-8) were used to assess depression, social support, and oral frailty, respectively. The differences in oral frailty scores among the patients with varying clinical characteristics were analyzed. Pearson correlation analysis was performed to analyze the correlations of depression and social support with oral frailty. The Bootstrap method was used to test the mediating effect of depression between social support and oral frailty. Results The mean score of oral frailty of the elderly stroke patients was 4.095±2.34, and 206 cases (51.5%) presented with oral frailty. Univariate analysis showed that gender, age, education level, marital status, sleep status, long-term medication history, and smoking history significantly influenced the level of oral frailty (P<0.05). Pearson correlation analysis indicated that social support was negatively correlated with both oral frailty (r=-0.636, P<0.001) and depression (r=-0.458, P<0.001), while depression was positively correlated with oral frailty (r=0.553, P<0.001). Bootstrap analysis revealed that social support directly affected oral frailty, with the direct effect of -0.235 (95%CI:-0.284 to -0.186) accounting for 74.84% of the total effect. Depression partially mediated the relationship between social support and oral frailty, with a mediated effect of -0.079 (95%CI:-0.110 to -0.051) accounting for 25.16% of the total effect. Conclusions Elderly stroke patients have a high prevalence of oral frailty. Enhancing social support and improving depression may help reduce the risk of oral frailty.

Key words: aged, stroke, depression, oral frailty, social support